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Common Childbirth Practice Could Lead to Later False Diagnosis of Shaken Baby Syndrome

Synthetic Oxytocin, or Pitocin, is often used to induce labor in childbirth. It also can cause some of the same symptoms as Shaken Baby Syndrome.

by Terri LaPoint

Health Impact News

Pitocin is one of the most commonly used drugs in childbirth, given to the majority of birthing women to either induce or augment (speed up) labor.

Cytotec is also used by many doctors to induce labor.

As common as they are, they are not without significant risks to both mother and baby.

These are known side effects that are rarely, if ever, told to parents. The risks to the baby include:

  • retinal hemorrhage
  • brain hemorrhage, or brain bleeding
  • neonatal jaundice
  • brain damage, including Hypoxic Ischemic Encephalopathy
  • lower APGAR scores at 5 minutes
  • neonatal seizures
  • death

Unfortunately, some of these risks also appear on the list of symptoms of Shaken Baby Syndrome (SBS), or, as it is sometimes called, Abusive Head Trauma (AHT).

Doctors have been taught to diagnose SBS when “the triad” of symptoms is present – 1) subdural hematoma, or brain bleeding, 2) retinal hemorrhage, and 3) brain swelling, or encephalopathy.

Often this diagnosis is made absent any other symptoms, and without any history of violence or abuse in the accused parent.

Once any of the symptoms in the triad are seen, doctors, especially Child Abuse Specialists, typically stop looking for any other explanation for the symptoms.

Though the American Academy of Pediatrics (AAP) and other organizations assert that the “science is settled” in regards to SBS, there are doctors who disagree with the standard dogma that the “triad” of symptoms equals SBS.

The science is clearly not settled, and the courts agree. All across the U.S. SBS convictions are being overturned in cases where parents or care givers were convicted solely on SBS diagnoses absent other scientific evidence presented in defense of the accused.

Joe Whitaker was sentenced in February 2017 to 15 years in prison for Shaken Baby Syndrome. Exonerating evidence by medical experts was ignored. See story.

There are many things besides child abuse that can cause symptoms of Shaken Baby Syndrome, including vaccines. Even normal childbirth can result in some of these symptoms.

How many accused parents are aware that simply having labor induced or augmented could cause Shaken Baby symptoms in their baby?

Perhaps more importantly, how many doctors, social workers, attorneys, and judges are aware of this? Or are they aware, but choose not to disclose this information?

Pitocin

Pitocin is a synthetic form of the hormone Oxytocin, which is responsible for causing uterine contractions.

Oxytocin is released in the mother’s body during labor. Both mother and baby release oxytocin during breastfeeding.

It also plays a prominent role in lovemaking and in sucking. It has been called the hormone of trust, because it helps to create a bond of trust when it is released.

Oxytocin molecule necklace

Oxytocin molecule necklace. Photo provided by Carla Hartley, founder of the Trust Birth Initiative.

When labor is induced, a synthetic form of oxytocin known as Pitocin is commonly used. The body doesn’t respond to the artificial version in the same way that it responds to its own naturally-produced oxytocin, and therefore, there are side-effects.

It is given to women in an IV to induce labor. In a mother already in labor, sometimes nurses will tell the mother that the “medicine” is being given to “help labor along.”

Either way, it is the most commonly used drug in birthing women.

Pitocin can cause very strong (hypertonic) or prolonged (tetanic) contractions, which can put excess pressure on the baby’s brain or cause the baby to receive inadequate oxygen.

Besides the increased risk of uterine rupture to the mother, induced labor puts extra pressure on the baby. The use of artificial oxytocin inhibits the baby’s ability to produce pain-relieving endorphins that would happen if labor were natural.

Sicor Pharmaceuticals manufactures Synthetic Oxytocin Injection, USP, and lists side effects for the baby and mother on the package, including retinal hemorrhaging and brain damage. (Source)

These brain injuries include brain swelling and brain bleeding.

Cytotec and Other Risks for Brain Injury

Cytotec (misoprostol) is an inexpensive alternative for inducing labor, but it is linked with severe tetanic contractions, which can lead to brain injuries in the baby.

Cytotec is an ulcer drug that is still being used off-label to induce labor, even though its manufacturer says that it should never be used on pregnant women:

In August 2000, the original manufacturer of Cytotec, G.D. Searle & Co. (Searle), sent a letter to over 200,000 OB/GYNs in the country stating the possible side effects of Cytotec when given to pregnant women, such as hyperstimulation of the uterus, uterine rupture, fetal bradycardia, amniotic fluid embolism, death of the mother, and death of the child. (Source) Nonetheless, the American Congress of Obstetricians and Gynecologists (ACOG) continues to support its use. Doctors and some who call themselves midwives continue to use the drug to ripen the cervix and induce labor.

It is administered in the form of a small pill, which is quartered and placed in the mother’s vagina near the cervix. Unlike pitocin in an IV that can be turned off, once cytotec dissolves, its effects cannot be stopped, even if the contractions are extreme or causing fetal distress.

Cytotec FDA warning

FDA warning against Cytotec for labor.

Mothers and babies have died from this drug, but how many more babies have had side effects that were not detected, only to be discovered later when the parents are accused of Shaken Baby Syndrome?

Most women are never told that these drugs can cause such side effects. These interventions are so common as to be part of the typical experience of hospital birth.

Instrumental birth, such as delivery with forceps or vacuum extractor, is well-known for increasing the risk for injury, such as intracranial hemorrhage, or brain bleeding. Prematurity also increases the risk for complications such as intracranial hemorrhage, due to the “fragility of their underdeveloped blood vessels.” (Source)

Even Normal Birth Can Result in Shaken Baby Symptoms

A 2015 study concluded that retinal hemorrhage (RH) occurs in about 1 out of 4 healthy, full-term births:

RH is common in full-term newborns.

Steven Gabaeff, M.D., is a doctor of Emergency Medicine and Clinical Forensic Medicine, and he points out that almost half (46%) of the newborns examined by MRI for one study were found to have subdural hematomas.

These were “normal” births that were screened. According to Gabaeff:

Any augmentation to labor, (pitocin or instrumentation forceps or vacuum extraction), or forceful pushing combined with any bony dystocia (too small a pelvis) or malpositioning of the fetus, increases the forces on the head during contractions.

Each of these factors may increase the probability of PSDH [perinatal subdural hematoma] and the amount of bleeding that occurs. In fact, Rooks found that 84% of neonates with cephalohematoma (molding of the head due to bleeding beneath the scalp) had SDH [subdural hematoma].

She also found 18% of all c-sections had PSDH and 75% of those had been in labor and had pitocin drips before c-section. (Source) Dr. Gabaeff’s 2013 study presents much valuable information for parents falsely accused of SBS and for their attorneys:

Investigating the possibility and probability of perinatal subdural hematoma progressing to chronic subdural hematoma, with and without complications, in neonates, and its potential relationship to the misdiagnosis of abusive head trauma

In his 2011 study, Dr. Gabaeff points out that it is not even the entire “triad” that is needed to accuse parents of abuse. Retinal hemorrhage and subdural hematoma, whether seen together or separately, have been used even independently:

to make the diagnosis and initiate criminal proceedings. However, both SDH and RH can result from a number of other traumatic or medical conditions. See:

Challenging the Pathophysiologic Connection between Subdural Hematoma, Retinal Hemorrhage and Shaken Baby Syndrome

Doctors do not routinely perform MRIs on newborns, but these studies suggest that, if they did, many of the babies later found to have symptoms of Shaken Baby Syndrome may actually have had some of those symptoms before they ever left the hospital after birth, and were, therefore, not the result of abuse.

Basic medical thought is that these injuries from birth resolve on their own, so that, if the symptoms are found later, the later symptoms must be abuse.

The American Academy of Pediatrics, which dictates the policies and practices of pediatricians, plays a significant role in parents being suspected of abuse in such cases. According to Gabaeff:

The position of the American Academy of Pediatrics (AAP) and the several hundred newly board certified child abuse pediatricians (BCCAP) who strongly influence its’ policies, is that all 2,000,000 cases of PSDH resolve without complications by 5–8 weeks of age.

He points out that this ignores the fact that:

crying, vomiting, or even normal handling have caused observable, often symptomatic episodic rebleeds. (Source) Medical Heresy to Question Shaken Baby Doctrine

Even though all of these factors are known by the medical community as situations that can cause these symptoms, it has become deeply ingrained medical and cultural dogma that “the triad = Shaken Baby Syndrome.”

Those who question or challenge that dogma are ostracized and vilified.

Almost like Galileo was branded a heretic for challenging the religious dogma of his day that the sun revolved around the earth, doctors who dispute the doctrine of Shaken Baby Syndrome may be excommunicated by the medical community.

There are doctors, scientists, attorneys, journalists, and, obviously, innocent parents who believe that there are other explanations for the symptoms of Shaken Baby Syndrome.

Circular Reasoning

We frequently hear from parents who are blindsided by a diagnosis of Shaken Baby Syndrome and subsequent arrest for child abuse, after simply taking their child to the doctor or Emergency Room when their child becomes lethargic or acts uncharacteristically.

At Health Impact News, we have noted a pattern of many of these occurrences happening shortly after the child was given multiple vaccines on the same day.

However, some cases don’t fit into that pattern. Could induction of labor, or even the pressures of normal birth, account for some of these cases?

Gabaeff notes that brain rebleeding can occur after bouts of crying or vomiting. Experts in Shaken Baby Syndrome assert that many cases of SBS occur when caregivers become frustrated with a crying baby.

Could this be circular reasoning, resulting in blame being placed on innocent caregivers? A baby crying results in a brain rebleed, which leads to the baby developing complications from the brain bleeding.

Then, the parent explains to doctors that the baby was crying, which leads doctors, especially Child Abuse Pediatricians, following AAP guidelines to accuse the parent of abuse instead of looking for another cause for the brain bleeding.

Once Abuse Is Mentioned, Doctors Stop Looking for Other Causes

Many parents have told Health Impact News that they are frustrated with doctors seeming to take the easy way out and not doing an adequate job of looking for what is really wrong with their child. Once the term “abuse” has been tossed out in the E.R. or hospital, too many doctors stop looking for other possible answers.

After Keshia and her husband were accused of Shaken Baby Syndrome and abuse, doctors stop looking for what was really wrong with her baby. After 2 1/2 years, her children are finally back home. See story. Photo provided by family.

Dr. Gabaeff says that this practice is:

scientifically and legally improper and allows for more latitude for child abuse pediatricians to diagnose abuse with less reliable evidence.

Confounding the findings based approach when abuse is “diagnosed”, consideration of work-ups for other causes are often truncated or abandoned. Meaningful differential diagnosis often ceases.

The three major etiological categories of events relevant to infants in this situation: birth trauma, accidental injury and medical problems are dismissed in favor of an abuse narrative based on the “findings”.

Allegations are then often ironically advanced under the rubric that there is no other plausible explanation for the blood (SDH [subdural hemorrhage] and RH [retinal hemorrhage]) or any other findings.

This position resonates with a long applied conventional approach among child abuse pediatricians and their colleagues that “SDH and RH are abuse until proven otherwise.” Parents find that action is swift and presumes their guilt:

Under these circumstances, it is virtually certain that “concerns for,” “suggestion of,” or “suspicions of” AHT will eventually enter the medical record and child protective services and the police will be activated. The default diagnosis is abuse or Shaken Baby Syndrome, and lives are ripped apart.

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